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Erectile dysfunction and HTLV-I infection: a silent problem

Abstract

The human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with a chronic myelopathy known as HTLV-I-Associated Myelopathy or Tropical Spastic Paraparesis (HAM/TSP). The main objective was to assess the frequency of erectile dysfunction (ED) in HTLV-I-infected individuals from Salvador and other cities from Bahia, Brazil, as well as to verify if sexual dysfunction correlates with urinary symptoms and overall neurological impairment. From January 2001 to April 2004, 218 HTLV-I carriers (111 male and 107 female subjects) had complete clinical, neurological, and urological evaluation. They were assessed using standardized questionnaires to determine urinary complaints (Urinary Distress Inventory) and ED (Brief Male Sexual Function Inventory). Neurological impairment was established by Expanded Disability Status Scale (EDSS) from 0 to 10. HAM/TSP was considered as EDSS≥2. A total of 17 males had clinically defined HAM/TSP (group 1). From the 94 HTLV-I-infected males, 62 were selected (group 2) and paired by age with patients in group 1. A total of 79 individuals were selected for this study. The age ranged from 35 to 81 y (mean=47.9±9.65). The percentage of ED in the studied population was 40.5%. In the HAM/TSP group, ED frequency was 88.2%. The associations among sexual dissatisfaction, erectile dysfunction, urinary symptoms (frequency, nocturia, and urgency) and EDSS≥2 were statistically significant. In HAM/TSP, there is a slow and progressive degeneration of the lateral funiculus of the spinal cord. HTLV-I-infected individuals present a high frequency of ED and it is closely associated to urinary symptoms and the overall neurological picture. The HTLV-I carriers already had prominent compromise of the sexual activity.

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References

  1. Gessain A et al. Antibodies to human T-lymphotropic virus type-I in patients with tropical spastic paraparesis. Lancet 1985; 2: 407–410.

    Article  CAS  Google Scholar 

  2. Osame M et al. HTLV-I associated myelopathy, a new clinical entity. Lancet 1986; 1: 1031–1032.

    Article  CAS  Google Scholar 

  3. Bangham CR . HTLV-1 infections. J Clin Pathol 2000; 53: 581–586.

    Article  CAS  Google Scholar 

  4. Araujo Ade Q et al. Clinical and demographic features of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) in Rio de Janeiro, Brazil. Acta Neurol Scand 1993; 88: 59–62.

    Article  Google Scholar 

  5. Araujo Ade Q et al. HTLV-I infection and neurological disease in Rio de Janeiro. J Neurol Neurosurg Psychiatry 1992; 55: 153–155.

    Article  Google Scholar 

  6. Leads from the MMWR. Licensure of screening tests for antibody to human T-lymphotropic virus type I. JAMA 1989; 261: 513, 518–520, 525.

  7. Feldman HA et al. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Article  CAS  Google Scholar 

  8. de Boer BJ et al. Erectile dysfunction in primary care: prevalence and patient characteristics. The ENIGMA study. Int J Impot Res 2004; 16: 358–364.

    Article  CAS  Google Scholar 

  9. Kurtzke JF . Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444–1452.

    Article  CAS  Google Scholar 

  10. Harvey MA, Kristjansson B, Griffith D, Versi E . The Incontinence Impact Questionnaire and the Urogenital Distress Inventory: a revisit of their validity in women without a urodynamic diagnosis. Am J Obstet Gynecol 2001; 185: 25–31.

    Article  CAS  Google Scholar 

  11. O'Leary MP et al. A brief male sexual function inventory for urology. Urology 1995; 46: 697–706.

    Article  CAS  Google Scholar 

  12. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

  13. DasGupta R, Fowler CJ . Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs 2003; 63: 153–166.

    Article  CAS  Google Scholar 

  14. Zorzon M et al. Sexual dysfunction in multiple sclerosis: a case–control study. I. Frequency and comparison of groups. Mult Scler 1999; 5: 418–427.

    CAS  PubMed  Google Scholar 

  15. Betts CD, Jones SJ, Fowler CG, Fowler CJ . Erectile dysfunction in multiple sclerosis. Associated neurological and neurophysiological deficits, and treatment of the condition. Brain 1994; 117: 1303–1310.

    Article  Google Scholar 

  16. Mazza O, Zeller F . Tratamiento farmacológico de la disfunción eréctil. Editorial Panamericana: Buenos Aires, 1997.

    Google Scholar 

  17. Aye MM et al. Histopathological analysis of four autopsy cases of HTLV-I-associated myelopathy/tropical spastic paraparesis: inflammatory changes occur simultaneously in the entire central nervous system. Acta Neuropathol (Berl) 2000; 100: 245–252.

    Article  CAS  Google Scholar 

  18. Kasahata N et al. Acute human T-lymphotropic virus type 1-associated myelopathy: a clinicopathologic study. Arch Neurol 2003; 60: 873–876.

    Article  Google Scholar 

  19. Castro-Costa CM et al. Neuropathology of two Brazilian autopsied cases of tropical spastic paraparesis/HTLV-I associated myelopathy (TSP/HAM) of long evolution. Arq Neuropsiquiatr 2002; 60: 531–536.

    Article  Google Scholar 

Download references

Acknowledgements

We are indebted to Dr Sidney Glina for reviewing the manuscript, advice and encouragement; Dr Valdir Lisboa from STS for referring eligible patients to our study. We also thank other members of the HTLV-I Multidisciplinary Outpatient Clinic for collaboration during the study: Dr Maria Aurélia Porto and Dr Adelmir Machado. This work was supported by the Brazilian National Research Council (CNPq) and Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB). Edgar M Carvalho is a senior investigator of CNPq.

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Correspondence to N Castro.

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Castro, N., Oliveira, P., Freitas, D. et al. Erectile dysfunction and HTLV-I infection: a silent problem. Int J Impot Res 17, 364–369 (2005). https://doi.org/10.1038/sj.ijir.3901335

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